NPI | 1124455829 |
---|---|
Former Name | MARY RUTH CACHO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: CO DEN.00203497) |
Additional Taxonomies | 122300000X Dentist (Licence: TX 28880) |
Enumeration Date | 2013-09-26 |
Last Update Date | 2019-02-14 |